DNA Damage Resp in Gastric Cancer

OriginalOriginal
Paper Paper
Original Paper
PathobiologyPathobiology
2013
2014;81:25–35
Pathobiology
2014;81:25–35
DOI: 10.1159/000351072
DOI: 10.1159/000351072
Received: November
7, 2013
Received:
October 25, 2012
Received: October
25, 2012
Accepted after
revision:
10,3,revision:
2013
Accepted
after
Accepted
afterDecember
revision: April
2013 April 3, 2013
Published
Published online:
August online:
21, 2013August 21, 2013
Received: October 25, 2012
Accepted after revision: April 3, 2013
Published online: August 21, 2013
Pathobiology 2014;81:25–35
DOI: 10.1159/000351072
of
Novel
TransmembraneProteins
Proteins
in
DNA
Damage
Response-Related
Proteins
DNAIdentification
Damage
Response-Related
Scirrhous
Type
Gastric Cancer
by
Escherichia
coli Ampicillin
in Gastric
Cancer:
ATM,
Chk2
and
in Gastric
Cancer:
ATM,
Chk2
and
p53 p53
DNA
Damage
Response-Related
Proteins
Secretion Trap (CAST) Method: TM9SF3 Participates in
Expression
and
Their
Prognostic
Value
Expression
and
Their
Prognostic
Value
in
Gastric
Cancer:
ATM,
Chk2
and
p53
Tumor Invasion and Serves as a Prognostic Factor
Expression
andSentani
Their
Prognostic
Value
Hee Eun Lee
Min A Kim
Hye Seung Lee
Hee Eun Lee
Nayoung Han
Hye Seung Lee
Htoo
Zarni
Oo Nayoung Han
KazuhiroMin A Kim
Naoya
Sakamoto
Katsuhiro Anami
a, b
a, ba
a, b
a, b
aa, b
a, b
b, ea
b, e
a
c
d
a, b, d
c
d
a, b, d
Han-Kwang Yang
Byung Lan Lee
a
b Woo Ho Kim
c
Han-Kwang Yang
Byung Lan Lee
Woo Ho Kim
a, b Yanagihara
Yutaka
Naito
Takashi
Oshima
Kazuyoshi
Naohide
Ouea
a, b
a, b
b, e
Hee Eun Lee
Nayoung Han
Min A Kim
Hye Seung Lee
a
c
a
c
of Pathology,
Seoul
NationalHospital,
University
Hospital, Departments
of band
Pathology
and
a National
DepartmentDepartment
of Pathology,
Seoul
University
Departments
of b Pathology
Surgery
andSurgery and
c Byung Lan Lee
d Woo Ho Kim
a, b, d
d
e
Wataru
Yasui
Han-Kwang Yang
d
e
CancerInstitute,
Research
Institute,
Seoul
NationalCollege
University
College ofSeoul
Medicine,
, and Department
of Pathology,
Cancer Research
Seoul
National
University
of Medicine,
, and Seoul
Department
of Pathology,
NationalBundang
UniversityHospital,
Bundang
Hospital, ,Seongnam
, South Korea
aaSeoul
Seoul National
University
Seongnam
South University
Korea
Department
Hiroshima
Institute
of Biomedical
and Health
Sciences,
Department of
of Molecular
Pathology,Pathology,
Seoul National
University
Hospital,
Departments
of b Pathology
and c Surgery
andHiroshima,
b
c
dGastroenterological Center, Yokohama City University Medical Center, Yokohama,
and Division
Translational
Cancer Research Institute, Seoul National University College of Medicine, Seoul , and e Department
of of
Pathology,
Research,
Exploratory
Oncology
Clinical
Trial Center,
National
Seoul National
University
Bundangand
Hospital,
Seongnam
, South
Korea Cancer Center Hospital East, Chiba, Japan
E-Mail karger@karger.com
www.karger.com/pat
Department of Pathology, Seoul National University College of Medicine
Department of Pathology, Seoul National University College of Medicine
28 Yeongeon-dong, Jongno-gu
28 Yeongeon-dong, Jongno-gu
Seoul 110-799 (South Korea)
Seoul 110-799 (South Korea)
E-Mail MD,
woohokim @ snu.ac.kr
Yasui,
Dr.
@ snu.ac.kr
E-MailWataru
woohokim
Woo PhD
Ho Kim
DepartmentDepartment
of Molecular
of Pathology
Pathology, Seoul National University College of Medicine
Hiroshima University
Institute Jongno-gu
of Biomedical and Health Sciences
28 Yeongeon-dong,
1-2-3 Kasumi,
Minami-ku,
Hiroshima
Seoul
110-799 (South
Korea)734-8551 (Japan)
snu.ac.kr
woohokim
Tel. +81 82E-Mail
257 5147,
E-Mail @
wyasui@hiroshima-u.ac.jp
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E-Mail karger@karger.com
E-Mail karger@karger.com
www.karger.com/pat
www.karger.com/pat
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Key Words Introduction CAST ⠂Gastric cancer ⠂TM9SF3 ⠂Prognosis ⠂ Key Words
relatedhad
proteins
a more favorablethan
outcome than others.
Key Words
relatedGastric
proteins
morehad
Transmembrane 9 superfamily member 3 cancera(GC)
isfavorable
a major outcome
cause of deathothers.
from
Stomach
neoplasm
·
DNA
damage
response
·
Ataxia
Multivariate
analyses
showed
that
Chk2
and at least 1
Stomach neoplasm · DNA damage response · Ataxia
Multivariate
showed
that
Chk2and
loss
and atloss
least
malignantanalyses
disease all
over the
world
develops
as
a re-1
telangiectasia
mutated
protein
·
Checkpoint
kinase 2 ·
aberrant
DDR-related
protein
remained
as
independent
telangiectasia
mutated protein · Checkpoint kinase 2 ·
aberrant
protein
remained
asalterations
independent
sult ofDDR-related
multiple
genetic
and
epigenetic
[1].
Key
Words
related proteins
had
a more favorable
outcome
than others.
Tumor
suppressor
protein
p53
·
Survival
analysis
·
prognostic
factors
of
poor
disease-specific
survival.
ConcluTumor suppressor
p53· ·DNA
Survival
analysis
·
factors
pooranalyses
disease-specific
survival.
ConcluAbstract Generally,
GCsofhave
been
classified
into
2 histological
Stomachprotein
neoplasm
damage
response
· Ataxiaprognostic
Multivariate
showed
that
Chk2
loss and at least 1
Immunohistochemistry
This
study
the
of
Immunohistochemistry
sions:
Thissions:
study
elucidated
the prognostic
implications
of
Objective: Scirrhous type gastric cancer is highly aggressive types:
an
intestinal
and aelucidated
diffuse
type
byprognostic
Lauren
[2], implications
oras
a independent
telangiectasia mutated protein · Checkpoint kinase 2 ·
aberrant
DDR-related
protein
remained
DDR-related
proteins,
and
suggests
that
their
aberrant
exand has a worse prognosis because of its rapid cancer cell differentiated
type
and
an
undifferentiated
type
by
Nakaproteins, and
suggests
thatdisease-specific
their aberrant exTumor suppressor protein p53 · Survival analysis · DDR-relatedprognostic
factors
of poor
survival. Conclupressions
play
critical
roles
in thetoward
development
and progresinfiltration, accompanied by extensive stromal fibrosis. The mura play
et
al.critical
[3], based
on
the
tendency
gland
forpressions
roles
in
the
development
and
progresImmunohistochemistry
sions: This study elucidated the prognostic
implications of
Abstract
sion
of
gastric
cancer.
Copyright
©
2013
S.
Karger AG, Basel
aim of this study is to identify genes that encode trans‐ mation.
Among
undifferentiated
type
GCs,
scirrhous
type
Abstract
sion of gastric
cancer.
Copyright © 2013 S. Karger AG, Basel
DDR-related
proteins,
and suggests that their aberrant exObjectives:
The
aims
of this
wereexpressions
to assess expressions
membrane proteins frequently expressed in scirrhous type GC has a worse prognosis than other types of GC, reflecObjectives:
The aims of
this
study
werestudy
to assess
pressions
play critical roles in the development and progresof
the
DNA
damage
response
(DDR)-related
proteins
and
to rapid
gastric cancer. Methods: We generated Escherichia coli am‐ ting
proliferation, progressive invasion, and a high
of the DNA
damage response (DDR)-related proteins and to
Abstract
sion
of
gastric
Copyright © 2013 S. Karger AG, Basel
picillin secretion trap (CAST) libraries from 2 gastric
human carcinoma.
scirr‐ frequency of metastasis cancer.
to the peritoneum [4].
Histologiinvestigate
their
clinical
significances
in
investigate
their
clinical
significances
in
gastric
carcinoma.
Objectives:
The
aims
of
this
study
were
to
assess
expressions
hous type gastric cancer tissues and compared with a nor‐ cally,
scirrhous
cancer
cells
show
diffuse
infiltration
of a
Methods:
Two independent
aset
training
set (n = 524)
Introduction
Methods:of
Two
independent
cohorts,
a cohorts,
training
(n = 524)
Introduction
the
DNA
damage
response
(DDR)-related
proteins
and
to
mal stomach CAST library. By sequencing 2,880 colonies broad
region
of
the
gastric
wall,
without
severely
affectand validation
set (n
394), cancer
of gastric
cancerwere
patients were
and validation
set (n = 394),
of =
gastric
patients
investigate
their
clinical
significances
in
gastric
carcinoma.
from scirrhous CAST libraries, we identified a (ATM),
list of candi‐ ing the mucosal
lining ofhas
the been
stomach.
Because
of the
such
enrolled.
Ataxia
telangiectasia
mutated
Gastric
reported
to be
fourth most
enrolled. Ataxia telangiectasia mutated (ATM), checkpointcheckpoint
Gastric
cancer
hascancer
been reported
to
be the fourth most
Methods:
Two
independent
cohorts,
a
training
set
(n =
524)
Introduction
date genes. Results: We focused on TM9SF3 gene because pathological
features,
early
clinical
diagnosis
of
scirrhous
kinase
2
(Chk2),
and
p53
expressions
were
examined
by
imcommon
cancer
and
the
second
leading
cause
kinase 2 (Chk2), and p53 expressions were examined by im- common cancer and the second leading cause of cancer-of cancerit and
has validation
the highest clone and immunohistochemical type GC
with death
gastrointestinal
series
endoscopy
rema- new casset
(n using
=count 394),tissue
of gastric
cancerResults:
patientsATM
were
munohistochemistry
microarray.
[1]
.or
More
thannew
930,000
related
worldwide
munohistochemistry
using tissue
microarray.
Results:
ATM
[1]
.
More
than
930,000
casrelated
death
worldwide
analysis demonstrated that 46 (50%) of 91 gastric cancer ins
difficult
despite
recent
advances
in
the
diagnosis
andthe fourth most
enrolled.
Ataxia
telangiectasia
mutated
(ATM), checkpoint
cancer
has
beendeaths
reported
be
loss,
Chk2
loss,
and
p53 positivity
were observed
in
21.8,
es areGastric
diagnosed
anddeaths
700,000
are to
attributed
loss, Chk2
loss,
and
p53
positivity
were
observed
in
21.8,
es
are
diagnosed
and
700,000
are
attributed
to
gas- to gascases were positive for TM9SF3 and it was observed fre‐ treatment
of
other
GCs
[5].
Actually,
there
are
no
good
kinase
2 (Chk2),
and
p53training
expressionsand
were
by im- tric
common
cancer and
second
leading
of cancer14.1,
36.1%
of the
in examined
17.3,
[2].the
Atsurgical
present,resection
surgicalcause
resection
is
cancer [2]
annually
14.1, andquently in scirrhous type gastric cancer. TM9SF3 expression 36.1%and
of the
training
set, and inset,
17.3, 12.2,
and 12.2,
. At present,
is
tricand
cancer annually
biomarkers
for this
type
of GC yet
and
therefore,
we
munohistochemistry
using
tissue
microarray.
Results:
ATM
[1]
.
More
than
930,000
new casrelated
death
worldwide
35.8%
of
the
validation
set,
respectively.
In
the
training
set,
the
mainstay
of
treatment,
but
even
after
potentially
cura35.8% ofshowed a significant correlation with the depth of invasion, the validation set, respectively. In the training set, the mainstay
ofgene
treatment,
butprofiling
even after
potentially
curaperformed
expression
using
scirrhous
type
loss,
Chk2 loss,
and p53ofpositivity
were
observed
in 21.8,
es resection,
are diagnosed
and 700,000
deaths
attributed
to gastheexpressions
aberrant
expressions
ATM,
Chk2,
or signifip53
were tive
signifitive
the
5-year
survival
is are
only
around 40%
the aberrant
of
ATM, Chk2,
ortype p53
were
resection,
the 5-year
survival
rate
is onlyrate
around
40%
tumor stage and undifferentiated of gastric cancer. GC
and
identified
several
candidate
GC-associated
genes.
14.1,
36.1% of
the
set, and
in 17.3,
12.2,disand [3–5]
tric. cancer annually [2] . At present, surgical resection is
cantlyand
associated
with
antraining
advanced
and poor
cantly associated
with an advanced
TNM stageTNM
and stage
poor dis[3–5]. To identify
There was a strong correlation between TM9SF3 expression potential molecular markers for GC and to
35.8%
of the survival.
validation
set,
respectively.
In the training
set, the
mainstay
of treatment,(TNM)
but evenstage
after potentially
ease-specific
This
association
was
verified
in
the
valTumor-node-metastasis
(by UICC/curaease-specific
survival. This association was verified in the valTumor-node-metastasis
(TNM) of
stage
(bytheUICC/
and poor survival prognosis of patients, validated in two se‐ better understand
the development
GC at
molethe
aberrant
expressions
of
ATM,
Chk2,
or
p53
were
signifitive
resection,
the
5-year
survival
rate
is
only
around 40%
idation
set.
Chk2
positivity
and p53
negativity
were AJCC)
signifiAJCC)
and completeness
surgicalare
excision
parate cohorts, by immunostaining or qRT‐PCR. Transient cular
level,
comprehensive
gene of
expression
analysis
isare consididation set.
Chk2
positivity
and p53 negativity
were signifiand
completeness
of surgical
excision
considcantly
associated
with
an
advanced
TNM
stage
and
poor
dis[3–5]
.
cantly
to aTM9SF3 prolonged
disease-specific
survival.
Also,
to be powerful
the most
powerful
prognostic
factors
knockdown of the gene by siRNA showed de‐ useful.
We most
previously
performed
several
large-scale
gene in gastric
cantly related
torelated
a prolonged
disease-specific
survival.
Also,
ered
to beered
the
prognostic
factors
in gastric
ease-specific
survival.
Thiscapacity. association
was
verified
in
the
val- cancer
Tumor-node-metastasis
(TNM) that
stage
(by canUICC/
patients
with
nonaberrant
expressional
levels
of
all
3
DDR[6]
.
However,
it
is
not
uncommon
creased tumor cell invasive Conclusion: Our re‐ expression
studies
using
array-based
hybridization
[6]gastric
patients with nonaberrant expressional levels of all 3 DDR- cancer [6]. However, it is not uncommon that gastric canidation
set. that Chk2TM9SF3 positivity
and
negativity
were signifiAJCC)
andofcompleteness
of surgical
excision
sults indicate might be p53
a potential diagnostic and serial
analysis
gene expression
(SAGE) [7],
[8] are considcantly related to a prolonged disease-specific survival. Also,
ered to
be thegenes
mostincluding
powerful
prognostic
factors in gastric
and therapeutic target for scirrhous type gastric cancer. and identified
several
regenerating
isletWoo Ho Kim
© 2013 S. Karger
AG, Basel levels of all 3 DDR- Dr.cancer
nonaberrant
expressional
[6]
.
However,
it
is
not
uncommon
that gastric can patients with
Dr. Woo Ho Kim
© 2013 S. Karger AG, Basel
derived family, member 4 (REG4, which encodes REGIV)
[9], [10], olfactomedin 4 (OLFM4) [11], palate, lung and
nasal epithelium carcinoma-associated protein (PLUNC)
[12], and GJB6 (encoding connexin 30) [13]. Recent
study on REGIV revealed that it also acts as a potential
biomarker for peritoneal dissemination of gastric cancer
[14]. Genes encoding transmembrane or secreted proteins
specifically expressed in cancers are ideal biomarkers for
cancer diagnosis and potential therapeutic targets. Our
recent study of Escherichia coli (E. coli) ampicillin secretion trap (CAST) analysis on 2 GC cell lines identified
several candidate genes encoding transmembrane proteins. Among them, Desmocollin 2 (DSC2) expression
was associated with GC of the intestinal mucin phenotype with CDX2 expression [15].
Here, we identified several genes that encode transmembrane proteins expressed in scirrhous type GC tissue.
Among these genes, we focused on the TM9SF3 gene
because this gene is frequently overexpressed in GC and
the most detected clone in our study. Moreover, there is
no reported study of TM9SF3 expression in GC. TM9SF3
encodes transmembrane 9 superfamily member 3 which
is one of the members of the TM9SF family also known
as nonaspanins [16], however, detailed function and
expression of the TM9SF3 gene in majority of human
cancers has not been elucidated. TM9SF3 was reported
as one of the genes overexpressed in chemotherapy resistant breast cancer cell lines by oligonucleotide microarray analysis [17].
This is the first study of CAST analysis on surgically
resected scirrhous type GC tissue. The present study also
represents the first detailed analysis of TM9SF3 expression in human GC and examines the relationship between
TM9SF3 staining and clinicopathological characteristics,
including tumor stage, TNM grading and histological
type. We clarified the pattern of expression and localization of TM9SF3 expression in GC, using surgicalllly
resected GC samples, by immunohistochemical analysis.
Furthermore, the biological role of TM9SF3 was examined in GC cell lines using an siRNA knockdown system
on cancer cell growth and invasion.
Materials and Methods CAST Library Construction
CAST library construction was performed as described
previously [18]. CAST is a survival-based signal sequence trap
that exploits the ability of mammalian signal sequences to
confer ampicillin resistance to a mutant β-lactamase lacking the
endogenous signal sequence [19]. For E. coli to survive the antibiotic challenge, the signal sequence and translation initiator
ATG codon must be cloned in-frame with the leaderless
2
Pathobiology 2013
β-lactamase reporter. In this study, to identify genes that present in scirrhous type GC, we generated CAST libraries from 2
human scirrhous type GC tissues. These 2 samples were obtained during surgery at Hiroshima University Hospital; one is
55-year old, female patient with Stage IIA (T3N0M0) and the
other is 62-year old, female patient with Stage IIIB (T4N2M0).
They were collected according to their enormous amount of accessible cancerous region, which was diagnosed by 2 pathologists. The RNA was obtained from the tumor core in the greater
curvature of the stomach, without necrosis area, for each case.
Each cDNA library was generated and ligated into the pCAST
vector, along with BamHI and EcoRI sites, for restrictive regulation of reverse transcription and directional cloning. Then,
the surviving ampicillin-resistant clones were picked up and
sequenced in 96-well format.
Tissue Samples
In total, 338 primary tumor samples were collected from patients diagnosed with GC. For immunohistochemical analysis,
we used archival formalin-fixed paraffin-embedded tissues
from 111 patients (Hiroshima cohort) who had undergone surgical excision for GC at the Hiroshima University Hospital or
affiliated hospitals, including 20 cases with their corresponding
lymph node metastasis. For quantitative reverse transcription-PCR (RT-PCR) analysis, 9 GC samples and corresponding
non-neoplastic mucosa samples were obtained during surgery at
the Hiroshima University Hospital. In Yokohama cohort, 227
GC cases from patients underwent surgery at the Gastroenterological Center, Yokohama City University Medical Center, and
at the Department of Surgery, Yokohama City University from
January 2002 through July 2007, were used for mRNA analysis.
Informed consent was obtained and ethics committee of
Yokohama City University Medical Center approved the guidelines. Noncancerous samples were purchased from Clontech
(Palo Alto, CA, USA). The 338 cases were histologically classified as differentiated type (papillary adenocarcinoma or tubular
adenocarcinoma) and undifferentiated type (poorly differenttiated adenocarcinoma, signet ring cell carcinoma or mucinous
adenocarcinoma), according to Japanese Classification of Gastric Carcinomas [20]. Tumor staging was according to International Union Against Cancer TNM classification of malignant
tumors.
Quantitative RT-PCR and Western Blot
Quantitative RT-PCR was performed with an ABI PRISM
7900 Sequence Detection System (Applied Biosystems, Foster
City, CA, USA) as described previously [21]. We calculated the
ratio of target gene mRNA expression levels between GC tissue
(T) and corresponding non-neoplastic mucosa (N). T/N ratios >
2 fold were considered to represent overexpression. β-actin
(ACTB gene) was used as housekeeping internal control.
Western blot was performed as described previously [22].
Immunohistochemical Evaluation
Immunostaining was performed with Dako Envision+ Mouse
Peroxidase Detection System (Dako Cytomation, Carpinteria,
CA, USA). Antigen retrieval with Proteinase K (Dako) for 5
minutes at room temperature. After peroxidase activity was
blocked with 3% H2O2-methanol for 10 minutes, sections were
incubated with mouse polyclonal anti-TM9SF3 (Abcam/
ab52889) antibody at 1:50 dilution for 1 hour at room temperature, followed by incubations with Envision+ anti-mouse
Oo/Sentani/Sakamoto/Anami/Naito/
Oshima/Yanagihara/Oue/Yasui
peroxidase for 1 hour. For color reaction, sections were incubated with DAB for 10 minutes, counterstained with 0.1% hematoxylin. When each specimen had more than 10% of cancer
cells stain, the immunostaining was considered positive according to median cut-off values rounded off to the nearest 5%
(range 0-80) for TM9SF3.
RNA Interference (RNAi)
To knockdown the endogenous TM9SF3, RNAi was performed. siRNA oligonucleotides for TM9SF3 and a negative control were purchased from Invitrogen (Carlsbad, CA, USA).
Primer sequences for 3 siRNAs are listed in the Supplementary
table. Transfection was done using Lipofectamine RNAiMAX
Reagent (Invitrogen) according to the manufacturer’s protocol.
Cell Lines, Cell Growth and in vitro Invasion Assays
Nine cell lines derived from human GC were used. The
TMK-1 cell line was established in our laboratory from a poorly differentiated adenocarcinoma [23]. Five GC cell lines of the
MKN series (MKN-1, adenosquamous cell carcinoma; MKN-7;
MKN-28; MKN-74, well-differentiated adenocarcinoma and
MKN-45, poorly differentiated adenocarcinoma) were kindly
provided by Dr Toshimitsu Suzuki (Fukushima Medical
University School of Medicine) [24]. KATO-III; HSC-39
(signet ring cell carcinoma) and HSC-57 (well-differentiated
adenocarcinoma) cell lines were kindly provided by Dr. Morimasa Sekiguchi (University of Tokyo) [25] and Dr Kazuyoshi
Yanagihara (Yasuda Women’s University) [26], respectively.
All cell lines were maintained in RPMI 1640 (Nissui Pharmaceutical Co, Ltd, Tokyo, Japan) containing 10% fetal bovine
serum (BioWhittaker, Walkersville, MD) in a humidified atmosphere of 5% CO and 95% air at 37°C. The MKN-28 cells were
seeded at a density of 2000 cells per well in 96-well plates. Cell
growth was monitored after day 0, 1, 2 and 4 for MTT assay, as
mentioned elsewhere [27]. Modified Boyden chamber assays
were carried out to examine invasiveness. Cells were plated at
200,000 cells per well in RPMI-1640 medium plus 1% serum in
the upper chamber of a Transwell insert (8 μm pore diameter;
Chemicon, Temecula, CA, USA) coated with Matrigel.
Medium containing 10% serum was added in the bottom chamber using 24-well plate format. On day 1 and 2, non- invading
cells in the upper chamber were removed by clean cotton swab
and the cells attached on the lower surface of the insert were
stained with Cell Stain (Chemicon, Temecula, CA, USA), and
the invading cells were counted with an ordinary light microscope.
Statistical Methods
Correlations between clinicopathological parameters and
TM9SF3 expression were analyzed by Fisher's exact test and
Log-rank test for Kaplan-Meier analysis. A P value of less than
0.05 was considered statistically significant. Statistical analyses
were performed using JMP software (version 9.0.2; SAS institute, Carey, NC).
Results Establishment of CAST Libraries
To identify genes that encode transmembrane proteins
expressed in scirrhous type GC, we generated CAST lib-
Role of TM9SF3 in Gastric Cancer
raries from 2 scirrhous type GC tissues and used a previously established normal stomach CAST library [15],
to compare gene expression profiles. In this fashion, we
detected and sequenced 1,440 ampicillin-resistant colonies from each scirrhous CAST library. Then, these sequences were compared to those deposited in the public
databases using BLAST (accessed at http://blast.ncbi.nlm.
nih.gov/Blast.cgi), and evaluated the subcellular localization of the gene products using GeneCards (accessed at
http://www.genecards.org/index.shtml). While unifying
2,880 colonies from 2 scirrhous type GC tissues, 711 colonies were human named genes, including 323 genes
which were cloned in-frame and upstream of the leaderless β-lactamase, in which 48 genes encoded secreted
proteins, 130 genes encoded transmembrane proteins,
and the remaining 145 genes encoded proteins that were
neither secreted nor transmembrane proteins. Because the
purpose of this study is to identify genes that encode
transmembrane proteins specifically present in scirrhous
type GC, we focused on transmembrane proteins expressed in the cancer tissue library.
Analysis of GC Specific Gene Expression in
comparison with Normal Tissue through CAS T Method
To determine genes expressed specifically in GC, we
compared the gene list from two GC tissue CAST libraries to the normal stomach CAST library. We selected
genes that were detected at least twice in each GC tissue
CAST library but not once in the normal stomach CAST
library. In total, 42 candidate genes were obtained, as listed in Table 1. We focused to TM9SF3 because it had the
highest number of clones counted in our candidate list,
moreover there is no detailed functional analysis of
TM9SF3 in human cancers yet. Here, we used bulk cancer tissue samples, which contain both cancer cells and
stromal components. Actually, some of the genes were
derived from stromal cells. For instance, CD74 is
associated with macrophage migration inhibitory factor
[28] and CD68 is a marker for the various cells of the
macrophage lineage [29]. High on the list, sarcoglycan is
well known for connecting the muscle fiber cytoskeleton
to the extracellular matrix [30]. These results suggested
that CAST is a robust and reliable technique to identify
novel genes.
Messenger RNA Expression of TM9SF3 in Systemic
Normal Organs and GC Tissues
Genes expressed at high levels in tumors and very low
levels in normal tissues are ideal diagnostic markers and
therapeutic targets. To confirm whether the TM9SF3
gene is cancer-specific, quantitative RT-PCR was performed in 9 GC tissue samples and in 13 kinds of normal
Pathobiology 2013
3
!"#$%&'( List of candidate genes specifically expressed in scirrhous type gastric cancer
DESCRIPTION
TM9SF3
CD74
SGCB
ITGB6
TSPAN8
CD63
SLCO2A1
ENPP4
SERINC3
ATP4B
CD68
SLC12A2
SLC16A7
ADAM9
ATP8B1
CDH17
CLCC1
CLDN7
ITFG3
FZD3
GPNMB
HLA-DRA
LMBR1
PKD2
PROM1
TFRC
TRPM7
ADAM17
CD55
DRAM2
DSC2
ENTPD1
ITLN1
MS4A6A
PCDH18
PCDHB9
SLC38A2
SLC4A4
TAOK3
TMBIM4
TNFSF13B
ZDHHC14
Homo sapiens transmembrane 9 superfamily member 3 (TM9SF3), mRNA.
Homo sapiens CD74 molecule, major histocompatibility complex, (CD74), transcript variant 2, mRNA.
Homo sapiens sarcoglycan, beta (43kDa dystrophin-associated glycoprotein) (SGCB), mRNA.
Homo sapiens integrin, beta 6 (ITGB6), mRNA.
Homo sapiens tetraspanin 8 (TSPAN8), mRNA.
Homo sapiens CD63 molecule (CD63), transcript variant 1, mRNA.
Homo sapiens solute carrier organic anion transporter family, member 2A1 (SLCO2A1), mRNA.
Homo sapiens ectonucleotide pyrophosphatase/phosphodiesterase 4 (putative function) (ENPP4), mRNA.
Homo sapiens serine incorporator 3 (SERINC3), transcript variant 1, mRNA.
Homo sapiens ATPase, H+/K+ exchanging, beta polypeptide (ATP4B), mRNA.
Homo sapiens CD68 molecule (CD68), transcript variant 1, mRNA.
Homo sapiens solute carrier family 12 (sodium/potassium/chloride transporters), member 2 (SLC12A2), mRNA.
Homo sapiens solute carrier family 16, member 7 (monocarboxylic acid transporter 2) (SLC16A7), mRNA.
Homo sapiens ADAM metallopeptidase domain 9 (meltrin gamma) (ADAM9), transcript variant 1, mRNA.
Homo sapiens ATPase, class I, type 8B, member 1 (ATP8B1), mRNA.
Homo sapiens cadherin 17, LI cadherin (liver-intestine) (CDH17), transcript variant 1, mRNA.
Homo sapiens chloride channel CLIC-like 1 (CLCC1), transcript variant 2, mRNA.
Homo sapiens claudin 7 (CLDN7), transcript variant 1, mRNA.
Homo sapiens integrin alpha FG-GAP repeat containing 3 (ITFG3), mRNA.
Homo sapiens frizzled homolog 3 (Drosophila) (FZD3), mRNA.
Homo sapiens glycoprotein (transmembrane) nmb (GPNMB), transcript variant 2, mRNA.
Homo sapiens major histocompatibility complex, class II, DR alpha (HLA-DRA), mRNA.
Homo sapiens limb region 1 homolog (mouse) (LMBR1), mRNA.
Homo sapiens polycystic kidney disease 2 (autosomal dominant) (PKD2), mRNA.
Homo sapiens prominin 1 (PROM1), transcript variant 1, mRNA.
Homo sapiens transferrin receptor (p90, CD71) (TFRC), mRNA.
Homo sapiens transient receptor potential cation channel, subfamily M, member 7 (TRPM7), mRNA.
Homo sapiens ADAM metallopeptidase domain 17 (ADAM17), mRNA.
Homo sapiens CD55 molecule, decay accelerating factor for complement (CD55), transcript variant 1, mRNA.
Homo sapiens DNA-damage regulated autophagy modulator 2 (DRAM2), mRNA.
Homo sapiens desmocollin 2 (DSC2), transcript variant Dsc2a, mRNA.
Homo sapiens ectonucleoside triphosphate diphosphohydrolase 1 (ENTPD1), transcript variant 1, mRNA.
Homo sapiens intelectin 1 (galactofuranose binding) (ITLN1), mRNA.
Homo sapiens membrane-spanning 4-domains, subfamily A, member 6A (MS4A6A), transcript variant 2, mRNA.
Homo sapiens protocadherin 18 (PCDH18), mRNA.
Homo sapiens protocadherin beta 9 (PCDHB9), mRNA.
Homo sapiens solute carrier family 38, member 2 (SLC38A2), mRNA.
Homo sapiens solute carrier family 4, (SLC4A4), transcript variant 2, mRNA.
Homo sapiens TAO kinase 3 (TAOK3), mRNA.
Homo sapiens transmembrane BAX inhibitor motif containing 4 (TMBIM4), mRNA.
Homo sapiens tumor necrosis factor (ligand) superfamily, member 13b (TNFSF13B), transcript variant 1, mRNA.
Homo sapiens zinc finger, DHHC-type containing 14 (ZDHHC14), transcript variant 1, mRNA.
tissue (liver, kidney, heart, colon, brain, bone marrow,
skeletal muscle, lung, small intestine, spleen, spinal cord,
stomach and peripheral leukocyte). TM9SF3 expression
was detected at low levels or lesser extent, in normal organs including the stomach. High TM9SF3 expression
was observed in 4 out of 9 GC tissues (44%) (Fig. 1a).
To validate the CAST data, TM9SF3 expression in GC
was investigated by quantitative RT–PCR in an additional 227 GC samples and corresponding non-neoplastic
mucosa. We calculated the ratio of target gene mRNA
expression levels between GC tissue (T) and corresponding non-neoplastic mucosa (N). T/N ratios > 2-fold
were considered to represent overexpression. TM9SF3
mRNA was upregulated in 63 of 227 cases (28%) (Fig.
1b).
4
CLONE
NO.
SYMBOL
Pathobiology 2013
55
50
22
21
16
14
10
7
7
6
6
6
6
5
5
4
4
4
4
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
Immunohistochemical Analysis of TM9SF3 in GC
To analyze tissue localization, pattern of distribution,
relationship between clinicopathologic parameters and
TM9SF3 in GC, we performed immunohistochemical
(IHC) analysis of TM9SF3 using a commercially available antibody. TM9SF3 expression was detected in 46
(50%) of 91 GCs and it showed a diffuse staining of
cancer cells from superficial to deep layer of both early
GC and advanced GC (Fig. 2a, b). Histologically,
TM9SF3 was observed more frequently in the undifferentiated type of GC than in differentiated GC (p =
0.0213) (Table 2). In high power field, it showed membranous pattern of staining in GC tissues and sometimes
we observed its cytoplasmic accumulation (Fig. 2c). In
corresponding non-neoplastic gastric mucosa, TM9SF3
Oo/Sentani/Sakamoto/Anami/Naito/
Oshima/Yanagihara/Oue/Yasui
Fig. 1. Quantitative RT–PCR analysis of TM9SF3. (a) TM9SF3 mRNA expression level in 13 normal tissues and nine GC samples (arbitrary units). (b) T/N ratio of TM9SF3 mRNA level between GC tissue (T) and corresponding non‐neoplastic mucosa (N) in 227 GC cases (Yokohama‐cohort). T/N ratio > 2‐fold was considered to represent overexpression. Upregulation of the TM9SF3 gene was observed in 28% of the total cases. was scarcely expressed (Fig. 2d) and it showed positive
staining of cancer cells invading lymphatic vessel (Fig.
2e). Next, we examined the relationship between
TM9SF3 expression and clinicopathological parameters.
TM9SF3 staining showed a significant correlation with
the depth of invasion (p = 0.0065), lymph node metastasis (p = 0.0101) and TNM stage (p = 0.0065). Furthermore, we grouped scirrhous type and non-scirrhous type
within undifferentiated type GC and it showed strong correlation between scirrhous type GC and TM9SF3
expression (p = 0.0156). There was no significant association between TM9SF3 expression and other parameters (age, gender or M grade).
Relationship between Expression of TM9SF3 and
Patient Prognosis
We also examined the relationship between TM9SF3
expression and survival prognosis in 91 GC cases. The
prognosis of patients with positive TM9SF3 expression
was significantly worse than in the negative cases (p =
0.0130) (Fig. 3a). According to the immunostaining result, we analyzed on the group of undifferentiated type
GC cases and it revealed poor survival probability in
TM9SF3 positive GC cases (p = 0.0131) (Fig. 3b). Moreover, there was a tendency between scirrhous type GC
with TM9SF3 expression and poor prognosis (p = 0.0695)
Role of TM9SF3 in Gastric Cancer
(Fig. 3c) and then, we performed a validated analysis on
Yokohama cohort (n = 227, analyzed by qRT-PCR),
which displayed a significant correlation between survival probability and TM9SF3 mRNA level upregulation
in scirrhous type GC (p = 0.0231) (Fig. 3d). This validation study mentioned that our immnunostaining data gave
a uniform consistency with a separate cohort. In this
cohort, TM9SF3 in scirrhous type GC is frequently overexpressed than corresponding non-neoplastic gastric mucosa, however, there was no correlation between clinicopathological features (age, TNM grade, tumor stage and
histology) and TM9SF3 expression (data not shown).
Taken together, it was concluded that TM9SF3 positive
GC has poor survival probability and especially in which
scirrhous type GC showed significant worse prognosis.
TM9SF3 Expression in Primary and Lymph Node
Metastatic Sites
Immunostaining of corresponding lymph node metastatic sites was performed to confirm the distribution of
TM9SF3 in metastatic deposits. Compared with the positive rate and staining pattern of TM9SF3 in primary
tumors, concordance rates were calculated as a combination of both positive and negative cases in primary and
metastasis, divided by the total number of cases. Concordance rates of TM9SF3 were 75% (15 of 20 gastric cancer
Pathobiology 2013
5
Fig. 2. Immunohistochemical staining of TM9SF3 in GC tissues. (a and b) TM9SF3 was detected in cancer cells from superficial to deep layer of undifferentiated type GC tissue. (x40 magnification; bar = 500 μm in a) (c) TM9SF3 expression was observed as membranous and cytoplasmic staining in cancer cells, but not in the surrounding stromal cells. (x200 magnification; bar = 100 μm) (d) In non‐cancerous epithelium, adjacent to gastric cancer cells, TM9SF3 showed a few or no expression. (e) Expression of TM9SF3 was observed in GC cells in lymphatic vessel (x100 magnification; bar = 200 μm in b, d, e). cases) (Supplementary Fig. 1 a and b).
6
Pathobiology 2013
Role of TM9SF3 Downregulation on Cell Growth and
Invasion in GC
TM9SF3 staining showed a significant correlation
with depth of invasion, lymph node metastasis and worse
Oo/Sentani/Sakamoto/Anami/Naito/
Oshima/Yanagihara/Oue/Yasui
Fig. 3. Cancer specific survival in two separate cohorts; Hiroshima cohort (n = 91, immunostaining) and Yokohama cohort (n = 227, qRT‐PCR). P value (log‐rank test) is shown in the right lower quadrant of each panel. (a) Patient prognosis of positive TM9SF3 expression in all GC cases, using immunohistological data. (b) Analysis of undifferentiated type GC cases. (c and d) Kaplan‐Meier plots of the cancer‐specific mortality of scirrhous type GC cases in the Hiroshima and Yokohama cohorts, respectively. prognosis in highly expressed GC cases, suggesting that
TM9SF3 may be associated with cancer cell growth and
invasion ability. However, the biological signifcance of
TM9SF3 in GC has not been studied. Initially, we
investigated TM9SF3 expression on 9 GC cell lines (Fig.
4a) and found strong expression in HSC-39 and MKN-28
cell lines. HSC-39 is derived from signet ring cell
carcinoma of the stomach and is an ideal cell line for this
study. Unfortunately, it is a floating cancer cell line and
difficult to transfect and process for experimental
procedures, and so we utilized MKN-28 cells for the
Role of TM9SF3 in Gastric Cancer
following analyses. Gene silencing in MKN-28 cells
were confirmed by Western blot (Fig. 4b). To investigate
the possible proliferative effect of TM9SF3, we performed an MTT assay 2 days after TM9SF3-siRNAs and
negative control siRNA transfection. There was no significant difference between TM9SF3 siRNA-transfected
MKN-28 cells and negative control siRNA-transfected
cells (Fig. 4c). Next, to determine the possible role of
TM9SF3 in the invasiveness of GC cells, a transwell
invasion assay was performed in the MKN-28 GC cell
line. Invasion ability was significantly downregulated in
Pathobiology 2013
7
Fig. 4. Effect of TM9SF3 downregulation on cell growth and cell invasion. (a) The anti‐TM9SF3 antibody detected at ~46 kD band on western blot of nine GC cell lines. β‐actin was used as a loading control. (b) Western blot analysis of TM9SF3 in MKN‐28 GC cells transfected with negative control siRNA or TM9SF3 siRNAs (siRNA 1–3). (c) Cell growth was assessed by an MTT assay on 96‐well plates in MKN‐28 cells. Bars and error bars show mean and s.d. of three different experiments. (d) Effect of TM9SF3 knockdown on cell invasion in MKN‐28 cells. MKN‐28 GC cells transfected with negative control siRNA or TM9SF3 siRNA‐1 and siRNA‐3 were incubated in Boyden chambers. After 24 and 48‐hour incubation, invading cells were counted. Bars and error bars show mean and s.d., respectively of three different experiments. O.D., optical density. N.S., not significant. (*, P < 0.05; **, P < 0.008). TM9SF3 knockdown GC cells compared with negative
control siRNA-transfected GC cells (Fig. 4d). These data
verify that TM9SF3 is associated with invasion of cancer
cells, but not with cancer cell growth in vitro.
Discussion In the present study, we generated CAST libraries
from 2 scirrhous type GC tissues, and identified several
genes that encode transmembrane proteins present in
scirrhous type GC. This is the first article analyzing surgically resected GC tissue samples by CAST method. We
emphasized on transmembrane proteins for their central
role as putative novel biomarkers and therapeutic targets
8
Pathobiology 2013
and observed that TM9SF3 showed the highest clone
count in the candidate list of the scirrhous CAST library.
Both quantitative RT-PCR analysis and immunohistochemistry revealed that TM9SF3 was frequently overexpressed in GC. The distribution of TM9SF3 in metastatic lymph nodes also showed the high concordance
rate. With regard to the TM9SF3 upregulation, this could
be explained by gain of DNA copy numbers in chromosome 10q24, which was reported in gastric cancer [31],
[32], where TM9SF3 gene is located. In addition, we
observed a significant correlation between TM9SF3 expression and poor survival prognosis, in two validation
studies.
TM9SF3 encodes transmembrane 9 superfamily member 3 which is one of the members of the TM9SF family.
Oo/Sentani/Sakamoto/Anami/Naito/
Oshima/Yanagihara/Oue/Yasui
TM9SF members are characterized by a large non-cytoplasmic domain and nine putative transmembrane domains [16]. This family is highly conserved through
evolution and four members are reported in mammals
(TM9SF1–TM9SF4), suggesting an important biological
role for these proteins. However, except for the recently
characterized genetic studies in Dictyostelium and Drosophila showing that TM9SF members are required for
adhesion and phagocytosis in innate immune response
[33], the biological functions of TM9SF proteins remain
largely unknown. Recent studies have demonstrated that
human TM9SF1 plays a role in the regulation of
autophagy [34] and human TM9SF4 involving in tumor
cannibalism and aggressive phenotype of metastatic
melanoma cells [35]. Using rat and Chinese Hamster
models, Sugasawa et al. [36] have reported that TM9SF3,
also known as SMBP, was the first member of TM9SF
with functional ligand binding properties. In addition,
TM9SF proteins have been found as endosomal or Golgilike distribution [16] and one of the TM9SF family
member, TM9SF2 has been found to be localized in
endosomal or lysosomal compartment [37]. It is consistent with our result that TM9SF3 showed cytoplasmic
accumulation as well as membranous staining pattern.
Based on our results, TM9SF3 expression was significantly correlated with tumor progression. In scirrhous
type GC, MMP-2 produced from stromal fibroblasts is
activated by MT1-MMP expressed by GC cells and
affects cancer progression in a paracrine manner [38].
Also, fibroblast growth factor-7 (FGF-7) from gastric
fibroblasts also affected the growth of scirrhous GC cells
[39]. Reciprocally, most fibroblasts were partially regulated by cancer cell-derived growth factors [40] such as,
TGFβ, platelet-derived growth factor (PDGF) and FGF2,
all of which are key mediators of fibroblast activation
and tissue fibrosis [41]. Thus, the growth-promoting factors from GC cells and tumor-specific fibroblasts mutually augment each other’s proliferation. Likewise, our present data also demonstrated that TM9SF3 positive scirrhous type GC cases had worse prognosis than negative
cases, in both sets of separate cohorts. Here, we suggest
that TM9SF3 could establish robust malignant behavior
of scirrhous GC cells by acting like a receptor, channel or
small molecule trans- porter in these cancer-stromal cell
interactions although the precise function of TM9SF3 is
unclear yet. Further investigations are indeed needed to
illuminate these hypotheses. On the other hand, in
Yokohama cohort, investigated on mRNA level, there
was no statistically significant correlation with clinicopathologic parameters including TNM grade and tumor
stage. It reflects that mRNA level, actually depends on
Role of TM9SF3 in Gastric Cancer
the amount of tissue obtained and it was difficult to
acquire tissue from deeper part of all GC samples.
During in vitro biochemical analyses of TM9SF3, a
basement membrane-coated cell invasion assay showed
that transient knockdown of TM9SF3 re- sulted in
suppression of invasive capacity of GC cells. We
speculate that human TM9SF3 might be involved in an
invasive mechanism of GC cells. The next crucial step
will be to elucidate how TM9SF3 is involved in the
tumor invasion process and whether it is scirrhous type
GC specific, in which cancer-stromal interactions have
been especially evident. In general, tumor cells at the
invasion front are considered to have more aggressive
and malignant behavior. Recent study on invasion front
of GCs showed that molecular expression of MMP-7,
laminin-gamma2 and EGFR was associated with T grade,
N grade and tumor stage [42]. However, GC is well
known for its intra-tumoral heterogeneity and so, it is
difficult to target the whole tumor mass because of such
heterogeneous expression of tumor markers. Targeted
therapy towards all malignant tumor cells is quite difficult and still required to identify. Here, TM9SF3 stained
at both mucosal region and invasion front of tumor mass
and thus, it might be a useful therapeutic target for GC.
Taken together, TM9SF3 is a promising prognostic
marker for cancer diagnosis of the stomach, especially in
scirrhous type GC. Evaluating the molecular mechanism
of TM9SF3 involvement in tumor-stroma interactions
might improve our understanding of GC carcinogenesis
and tumor progression. TM9SF3 expression may be a
key factor mediating the biological behavior of the scirrhous type GC. Furthermore, using CAST method, we
could identify unknown target genes and novel biomarkers for cancer diagnosis and management. In subsequent
study, it might be interesting to examine on a large number of GC samples to study the chemotherapy resistance
GC and novel candidates involving towards its molecular
mechanism.
Acknowledgments We thank Mr. Shinichi Norimura for his excellent
technical assistance and advice. This work was carried
out with the kind cooperation of the Research Center for
Molecular Medicine, Faculty of Medicine, Hiroshima
University (Hiroshima, Japan). We thank the Analysis
Center of Life Science, Hiroshima University, for the use
of their facilities. This work was supported in part by
Grants-in-Aid for Cancer Research from the Ministry of
Education, Culture, Science, Sports, and Technology of
Pathobiology 2013
9
Japan, in part by a Grant-in-Aid for the Third Comprehensive 10-Year Strategy for Cancer Control and for Cancer Research from the Ministry of Health, Labor and
Welfare of Japan, and in part by the National Cancer
Center Research and Development Fund (23-A-9).
Disclosure Statement The authors have no conflict of interest to disclose.
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Supplementary information Additional supplementary information can be found in online version of this article.
Role of TM9SF3 in Gastric Cancer
Pathobiology 2013
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